The Safety and Efficacy of the 1540nm Non-Ablative Fractional XD Probe of Star Lux 500 Device in the Treatment of Striae Alba: Before-After Study.

INTRODUCTION: Striae distensae (SD) are a frequent skin condition for which treatment remains a challenge. The 1540-nm non-ablative fractional laser (Star Lux 500) has been shown to improve atrophic scars by increasing the amount of dermal collagen. To assess the safety and efficacy of the Star Lux 500 laser in the treatment of mature hypopigmented striae in Persian people (Striae Alba). METHODS: Ten women aged 26-50 years with SD and Fitzpatrick skin types III-V were enrolled in the study. The exclusion criteria were a history of keloids, photosensitivity and collagen, elastin disorders as well as history of other striae treatment within one year. The lesions were treated with non-ablative fractional laser 1540nm, and a total of four treatments were given at 4-week intervals. Clinical standard photographs were taken before each treatment. Also, patients were followed up at 3 months after the last treatment. Clinical improvement was assessed by comparing baseline and post-treatment photographs by two independent blinded physicians using grading scale. Treatment efficacy analysis was performed via the comparison between the images taken before and after each treatment session. RESULTS: There was a clinically appreciable improvement in striae ranging from 1 to 24%. A significant improvement in striae between the 16-week treatment and the 4-week treatment was identified (P<0.0001). Three months after the final treatment, patients showed noticeable improvement in the striae, compared with baseline (P<0.048). Mild post inflammatory hyperpigmentation was observed in one patient after the 8-week treatment and mild to moderate acne occurred in another patient after 4 weeks of treatment. CONCLUSION: Therapy with Star lux 500 laser had clinically and statistically striae improvement with no adverse events. This may be a safe and an effective treatment modality for Striae Alba lesions.

The rate and pattern of bcl-2 and cytokeratin 15 expression in trichoepithelioma and nodular Basal cell carcinoma: a comparative study.

CONTEXT: Histopathological evaluations can differentiate between clinically resembling trichoepithelioma (TE) and basal cell carcinoma (BCC) unless the biopsy specimens are small or superficial. Previous studies used immunohistochemical evaluation for Bcl-2 and cytokeratin 15 (CK15), in attempts to differentiate between these two entities, with heterogeneous findings. AIMS: This study intended to compare the rate and patterns of Bcl-2 and CK15 expressions between specimens of TE and nodular BCC. SETTINGS AND DESIGN: Case-series including formalin-fixed, paraffin-embedded cutaneous biopsies. SUBJECTS AND METHODS: Twenty-two BCC and 12 TE specimens were stained for Bcl-2 and CK15 and examined microscopically. The rate and patterns of expressions were compared between the two groups. STATISTICAL ANALYSIS USED: Statistical analysis was performed using the statistical software (SPSS version 16.0; SPSS Inc., Chicago, IL, USA), Pearson Chi-square, or Fisher's exact tests, wherever appropriate. RESULTS: The two groups were comparable for the expression rate and patterns of Bcl-2 (86.4%: 5 central, 14 diffuse in BCC vs. 83.3%: 2 central, 8 diffuse in TE; P = 0.59 and 0.54 for rate and pattern, respectively). The rate of CK15 expression was significantly higher in TE specimens (66.7%: 4 central, 3 diffuse, 1 peripheral vs. 4.5%: 1 central; P < 0.001). The positive likelihood ratio in distinguishing the two neoplasms was 14.7 (95% confidence interval: 2.1-103.7). CONCLUSIONS: CK15 but not Bcl-2 staining may help in differentiating between BCC and TE even in BCCs with follicular differentiation.

The effect of methylprednisolone pulse-therapy plus oral cyclosporine in the treatment of alopecia totalis and universalis.

The exact etiology of alopecia areata is still unknown, and no completely effective treatment has been established. The use of oral steroids for treating this disorder is controversial and may have potential side effects. Relapses are also common upon withdrawal of the medication. The objective of this study was to evaluate the therapeutic and side effects of pulse-therapy with methylprednisolone combined with oral cyclosporine in severe alopecia areata, defined as alopecia totalis and universalis. Six patients with alopecia totalis and 12 patients with alopecia universalis were referred to our center. The patients were treated with monthly intravenous methylprednisolone in doses of 500 mg for three days and oral cyclosporine (2.5 mg/kg/day) for five to eight months. Responses were categorized as: "adequate" (i.e., hair regrowth on > or =70% of the affected area) and "inadequate" (i.e., hair regrowth on <70% of the affected area). Adequate response was observed in six (33%) patients: three with alopecia totalis and 3 with alopecia universalis. Responses were better in patients with alopecia totalis, age >20 years, negative history of atopy, negative family history of alopecia areata, presence of nail pitting, and pruritus in the affected area. No cases of relapses and no severe side effects were observed. Patients with severe and resistant alopecia areata, if properly selected, may benefit from intravenous methylprednisolone pulse-therapy plus oral cyclosporine.

Subantimicrobial-dose doxycycline in the treatment of moderate facial acne.

BACKGROUND: Acne is a common inflammatory skin disorder. Oral antibiotics play a significant clinical role in treating acne. OBJECTIVE: The purpose of this study was to compare the efficacy of doxycycline at antimicrobial and subantimicrobial doses for the treatment of acne. METHODS: A prospective, randomized, double-blind, controlled trial was performed. One hundred patients with moderate facial acne were randomized into 2 treatment groups, one receiving a tablet containing 20 mg of doxycycline to be taken twice daily and the other receiving a tablet containing 100 mg of doxycycline and a matching placebo tablet to be taken twice daily. RESULTS: Subantimicrobial-dose doxycycline administered twice daily for 3 months in patients with moderate inflammatory acne results in significant reduction in the number of total inflammatory lesions. There was an 84% reduction in number of papules and a 90% reduction in number of pustules with treatment. CONCLUSION: Subantimicrobial-dose doxycycline is an effective treatment for patients with moderate acne vulgaris.